A nosocomial outbreak of multidrug-resistant tuberculosis.

Abstract:

BACKGROUND:An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms. OBJECTIVE:To identify risk factors for transmission of Mycobacterium tuberculosis. DESIGN:Retrospective cohort study. SETTING:Private hospital. PARTICIPANTS:Patients and health care workers exposed to M. tuberculosis. MEASUREMENTS:Analysis of M. tuberculosis isolates, tuberculin skin testing, assessment of exposure, and assessment of participant characteristics. RESULTS:All seven M. tuberculosis isolates had matching DNA fingerprints. Of patients exposed to M. tuberculosis, those who developed tuberculosis had lower CD4+ T-lymphocyte counts (P = 0.02) and were more likely to be ambulatory (P = 0.03) than those who did not. Of 74 exposed health care workers, the 11 (15%) who had conversion on tuberculin skin testing were no more likely than those who did not have conversion to report that they always wore a respirator with a high-efficiency particulate air filter. CONCLUSIONS:Transmission of M. tuberculosis occurred in a hospital that did not have recommended isolation rooms. A respirator-fit testing program did not protect health care workers in this setting.

journal_name

Ann Intern Med

authors

Kenyon TA,Ridzon R,Luskin-Hawk R,Schultz C,Paul WS,Valway SE,Onorato IM,Castro K

doi

10.7326/0003-4819-127-1-199707010-00006

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

32-6

issue

1

eissn

0003-4819

issn

1539-3704

journal_volume

127

pub_type

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